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Found 321 results
  1. News Article
    Two patients have died as a result of NHS hospitals failing to heed warnings about the use of super-absorbent gel granules, which patients mistakenly eat thinking they are sweets or salt packets. A national patient safety alert has been issued by NHS bosses to all hospitals, ambulance trusts and care homes instructing them to stop using the granules unless in exceptional circumstances. An earlier alert in 2017 warned the granules, which are used to prevent liquid being spilled, had caused the death of one patient who choked to death after eating a sachet left in an empty urine bottle in their room. The 2017 alert warned hospitals there had been a total of 15 similar incidents over a six-year period between 2011 and 2017. The latest warning from NHS England says most hospitals concentrated on “raising awareness” rather than stopping the use of gel granules. Read alert Read full story Source: The Independent, 4 December 2019
  2. News Article
    A hospital has made changes after two patients were accidentally given medical air instead of oxygen. The two incidents, which took place at the Norfolk and Norwich University Hospital (NNUH), were classed as "never events" meaning they were serious but preventable. They happened to patients in November who were being handed over to the hospital by the East of England Ambulance Service. The patients should have been given oxygen but were given medical air instead which only contains 20pc oxygen. The ambulance service said in a message to staff: "Severe harm or death can occur, if medical air is accidentally administered to patients instead of oxygen. As per NNUH's request, with immediate effect, when handing over at the NNUH, all medical equipment and oxygen should be swapped only by an emergency department doctor or registered nurse." Read full story Source: Eastern Daily Press, 2 December 2019
  3. Content Article
    Recently the Financial Times health and data reports produced an incisive piece showing the world what is all too readily apparent to people in the NHS: bed capacity has been stretched to breaking point. The report said this “calls into question [the NHS’s] ability to meet a commitment to increase non-urgent hospital treatment by 30 per cent above pre-pandemic levels over the next three years”. It also demonstrates the dangerous congestion that is causing ambulances to stack up outside emergency departments and medically fit patients to languish in vital beds past their due time for discharge. This congestion is causing dangerous delays, leading to a rising number of serious incidents in ambulances queuing to get to the front door of the ED. There is doubtless much that can be done inside hospitals to improve efficiency, alleviate bottlenecks and improve patient flow.
  4. Content Article
    This report by the Healthcare Safety Investigation Branch (HSIB) has been published as part of a local pilot, which has been launched to evaluate HSIB’s ability to carry out effective investigations occurring between specific hospitals and trusts. After an evaluation, it will be decided whether this model can be implemented more widely by HSIB. This investigation reviewed the case of a woman who was taken to an emergency department by ambulance in April 2021, following a 999 call from her Granddaughter to the emergency operations centre. The emergency operations centre used the wrong NHS number for the patient, which was assigned to her for the duration of her stay in hospital and led to her being offered incorrect medication.
  5. Content Article
    Prehospital care is the care received by a patient from an emergency medical service before arriving at a hospital. This systematic review in the International Journal for Quality in Health and Care aimed to identify: how the prevalence and level of harm associated with patient safety incidents (PSIs) in prehospital care are assessed. the frequency of PSIs in prehospital care. the harm associated with PSIs in prehospital care.
  6. Content Article
    This review by Healthcare Inspectorate Wales considers the impact of ambulance waits outside emergency departments on the overall experience of patients, which included their safety, care, privacy and dignity. It covers the period between 1 April 2020 and 31 March 2021, during the Covid-19 pandemic. The report highlights that although patients were positive about their experience with ambulance crews, handover delays are having a detrimental impact upon the ability of the healthcare system to provide responsive, safe, effective and dignified care to patients. It makes 20 recommendations for consideration by the Welsh Ambulance Services NHS Trust, health boards and the Welsh Government.
  7. Content Article
    This book aims to teach the key principles of patient safety to a diverse audience: physicians, nurses, pharmacists, other healthcare providers, quality and safety professionals, risk managers, hospital administrators, and others. It is suitable for all levels of readers: from the senior physician trying to learn this new way of approaching his or her work, to the medical or nursing student, to the risk manager or hospital board member seeking to get more involved in institutional safety efforts. Understanding Patient Safety is divided into three main sections. In Section I, it describes the epidemiology of error, distinguishes safety from quality, discusses the key mental models that inform our modern understanding of the safety field, and summarises the policy environment for patient safety. In Section II, it reviews different error types, taking advantage of real cases to describe various kinds of mistakes and safety hazards, introduces new terminology, and discusses what we know about how errors happen and how they can be prevented. Although many prevention strategies will be touched on in Section II, more general issues regarding various strategies (from both individual institutional and broader policy perspectives) will be reviewed in Section III. After a concluding chapter, the Appendix includes a wide array of resources, from helpful Web sites to a patient safety glossary.
  8. Content Article
    In this blog post, Liv System’s Nigel Scard talks with Courtney Grant, a Senior Human Factors engineer with Transport for London (TfL). Nigel and Courtney worked together for a number of years at TfL on a number of station and line upgrade projects. A few years ago, Courtney applied his Human Factors and research skills with great tenacity, to a serious healthcare related incident which impacted him personally. This resulted in an important, lifesaving change to ambulance service procedures. In this interview, Courtney describes this in detail and also describes his recent work in supporting the Chartered Institute of Ergonomics and Human Factors (CIEHF) in supporting the response to the COVID-19 pandemic.
  9. Content Article
    West Midlands Ambulance Service has highlighted the death of a woman which it says was due to “being delayed on the back of an ambulance”, just two days after it warned that lives were ‘at risk’ from long handovers. Below is the full account from the organisation's board paper.
  10. Content Article
    This study in the Journal of Patient Safety assessed the occurrence of incidents in inter-hospital transport for critically ill patients, their potential consequences, and whether they are actually reported. Two different services in Norway were asked to self-report incidents after every inter-hospital transport of critically ill patients. The study found that only 1% of incidents were actually reported in the hospital’s electronic incident reporting system. It also highlighted that experts who examined the incidents were inconsistent in which incidents should have been reported and to what degree different interventions could have prevented them. The study results show the existing quality and safety challenges relating to inter-hospital transport of critically ill patients.
  11. Content Article
    "Patients wait up to 12 hours. Some die waiting. How long must we wait for this dire situation to improve?" The NHS is overwhelmed. Although Covid has shone a bright light on this, it alone did not create these problems. There are multiple reasons for failure writes the'Secret Paramedic' in this Guardian article.
  12. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to recognition of the acutely ill infant and child, recognising the difficulty in distinguishing between simple viral illnesses and life-threatening bacterial infections in very young patients. This Healthcare Safety Investigation Branch investigation reviewed the case of Mohammad, a baby who had become unwell and was taken to an emergency department by ambulance following a call to NHS 111. He arrived at 8.04pm and was considered to have a mild viral illness, subsequently being transferred to a paediatric observational ward, and discharged at 11.45pm with a diagnosis of likely bronchiolitis. At approximately 3.40am his mother contacted the ward as his condition worsened, which resulted in a 999 call. The ambulance crew did not consider that Mohammad was seriously ill so did not conduct a ‘blue light’ emergency transfer to hospital. Mohammad was admitted to the emergency department at approximately 4.40am and suffered a respiratory and then cardiac arrest at 5:28am, with attempts to resuscitate unsuccessful and stopped at 6:10am. Mohammad died of septicaemia caused by meningococcus (serogroup B) bacteria.
  13. Content Article
    Barbara Young fell downstairs at her home at 11.30am on 15 July 2021, sustaining multiple injuries including fractures of her ribs, spine and skull. Her family immediately called the emergency services and informed the ambulance call handlers that she had fallen downstairs, was not fully conscious and had sustained an apparently severe head injury. An ambulance subsequently arrived at 2.26pm and she was taken to hospital where, due to her reduced mobility, she developed pneumonia. Mrs Young’s conditioned worsened over the coming days and she died on 24 July 2021.  In her report, the Coroner raises concerns about the ambulance waiting time in this case, and more generally about ambulance response times in cases where elderly patients experience falls.
  14. Content Article
    Staff retention is a significant issue for ambulance services across the globe. Exploratory research, although minimal, indicates that stress and burnout, in particular, influence attrition within the paramedic profession. These need to be understood if their impact on retention is to be addressed.
  15. Content Article
    Delays in the handover of patient care from ambulance crews to emergency departments (EDs) are causing harm to patients. A patient’s health may deteriorate while they are waiting to be seen by ED staff, or they may be harmed because they are not able to access timely and appropriate treatment. This national investigation sought to examine the systems that are in place to manage the flow of patients through and out of hospitals and consider the interactions between the health and social care systems (the ‘whole system’). This report brings together the findings from the investigation’s three interim reports and provides an update since they were published. You can view the interim reports on the hub: Interim report 1 (16 June 2022) Interim report 2 (3 November 2022) Interim report 3 (27 February 2023)
  16. Content Article
    A casually centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors.  David Wales and Kristina Stiles have released this report looking at the burn survivor experience in the pre-hospital environment. The work makes ten operational recommendations and also two 'lessons learned' recommendations exploring strategic partnership working and the resulting fragmented services.
  17. Content Article
    NHS England commissioned a limited scope independent review into patient safety concerns and governance processes related to the North East Ambulance Service. Chaired by Dame Marianne Griffiths DBE, the review considered the facts surrounding a number of individual cases, reviewed the processes surrounding coronial investigations and reviewed the seven previous investigations and reviews undertaken by the ambulance service to determine if they were sufficient to fully understand and resolve issues.
  18. Content Article
    On the 9 October 2021 an investigation was carried out into the death of Ms Sandra Diane Finch, a 44 year old woman who had a history of Type 1 diabetes mellitus. The investigation concluded at the end of the inquest on 3 May 2023. The conclusion of the inquest was a narrative conclusion of ketoacidosis due to insulin depravation contributed to by neglect.  The cause of death was: 1a) Ketoacidosis 1b) Uncontrolled Type 1 Diabetes Mellitus 1c) Insulin depravation.
  19. Content Article
    This is the first national ambulance volunteering strategy, produced by the Association of Ambulance Chief Executives. It recognises the important role volunteers play in the ambulance service and outlines a national approach to volunteering that will be adopted between January 2023 and May 2024. The strategy covers mission, vision, principles and measures of success.
  20. Content Article
    This white paper from CEMBooks aims to unpick some of the deeper issues surrounding bed block and emergency department crowding from the perspective of a frontline medic with two decades of emergency and flow management experience. It aims to provide a greater understanding of the factors influencing the current situation and the measures used to define it followed by some practical implementable solutions.
  21. News Article
    Two acute trusts account for almost two-thirds of emergency department ‘diverts’ reported over the last two months. Between the start of December and the start of February, Worcestershire Acute Hospitals Trust and University Hospitals Sussex Foundation Trust implemented 122 temporary “diverts” between them – representing around 60% of the national total. The measure is taken when a particular site, such as Worcestershire Royal or Royal Sussex County Hospital, comes under significant pressure and ambulances are temporarily directed to an alternative hospital, usually within the same trust. NHS England guidance says diverts of emergency patients due to lack of physical or staff capacity to deal with attendances or admissions “should be an action of last resort” and that this “should only need to happen in exceptional circumstances, where internal measures have not succeeded in tackling the underlying problem”. Helen Hughes, chief executive of Patient Safety Learning, said: “For ambulance services, the impact of A&E diverts is two-fold. It both increases the length of journeys that crews have to make once a divert is implemented, and increases the travel time required to get back to subsequent emergency calls." “This has the potential to increase waiting times for patients, increasing the risk of avoidable harm, particularly for those who are seriously ill, frail or elderly.” Read full story (paywalled) Source: HSJ, 15 February 2022
  22. News Article
    Over half of paramedics are suffering from burnout caused by “overwhelming” workloads, record numbers of 999 calls and the public misusing the ambulance service, a study has found. Frontline crew members also blame lack of meal breaks, delays in reaching seriously ill patients and their shift often not ending when it should for their high levels of stress and anxiety. The working lives of ambulance staff are so difficult that nine out of 10 display symptoms of “depersonalisation”, characterised by “cynicism, detachment and reduced levels of empathy” when dealing with patients who need urgent medical treatment. The widespread poor mental welfare of paramedics is a problem for the NHS because it is leading to some quitting, thus exacerbating its shortage of ambulance personnel, the authors said. The findings, published in the Journal of Paramedic Practice, have prompted concern that the demands on crews, alongside the injury, violence and death they encounter, are storing up serious mental health problems for them, including post-traumatic stress disorder. “Ambulance staff are passionate about their role. However, burnout is a significant and very real issue that decreases staff efficacy and reduces quality of patient care,” the study said. It was undertaken by Rachel Beldon, who works for the Yorkshire ambulance service, and Joanne Garside, a professor and school strategic director of Huddersfield university’s health and wellbeing academy. “Participants wanted better resources and staffing levels. The current workload appeared to be overwhelming and negatively affected their mental health and work-life balance.” Read full story Source: The Guardian, 6 February 2022
  23. News Article
    An ambulance trust has apologised after a man having a heart attack said he was advised to get a lift to hospital or face a long wait. Graham Reagan said he was on the verge of collapsing when he finally got to York hospital after a lift from his son. Mr Reagan said he was concerned about the impact on patients with potentially life-threatening conditions. Speaking to BBC Yorkshire and Lincolnshire's Politics North programme, Mr Reagan described his experience as "scary". "I'd had indigestion, or so I thought, for a couple of days, and then on 17 December I went to bed early feeling rough," he said. In the early hours, Mr Reagan said the pains in his chest grew worse and he asked his wife to call for an ambulance. "I couldn't take it any more," he said. Mr Reagan, from Malton in North Yorkshire, said his wife was asked "can you get to hospital" as the nearest ambulance was about 20 to 30 miles away. "My wife doesn't drive, but fortunately my son was with us and he drove me to York hospital." On arrival Mr Reagan said they found the entrance to A&E had also been re-routed. "So, we then had to walk out of the hospital grounds and back in - by which time I'm collapsing," he added. He said staff at the hospital were "absolutely brilliant" and arranged for him to be transferred to Hull for treatment after a heart attack was confirmed. However, he said he was faced with a further 35-minute delay while he waited for an ambulance to take him. Mr Reagan said he wanted to share his experience to raise awareness. Read full story Source: BBC News, 16 January 2022
  24. News Article
    A health minister has asked NHS England to look into a stricken ambulance trust that is asking patients to get a lift to A&E. The North East Ambulance Service (NEAS) said staff should “consider asking the patient to be transported by friends or family.” See previous news story. NEAS medical director Dr Mathew Beattie said the service had “no option than to try to work differently” amid Covid staff shortages. However, Health Minister Gillian Keegan said she would ask NHS England to look into the situation. She told Sky News: "That is not what we have put in place at all. We have more ambulance crews in operation than we have ever had." “We also gave £55 million extra just for this period to cover staff and make sure we had increases in staff and staffing levels. "I've actually asked NHS England to look at that particular case because that doesn't sound to me like that's an acceptable approach. “People should be able to get an ambulance if they have a heart attack and that's why we've put that extra funding in place, and why we've been building up our ambulance service over the last couple of years." Read full story Source: Mirror, 5 January 2022
  25. News Article
    Ambulance trusts have begun asking patients with heart attacks and strokes to get a lift to hospital with family or friends instead of waiting for an ambulance, because of high covid absences and ‘unprecedented’ surges in demand, HSJ has learned. An internal note at North East Ambulance Service Foundation Trust said that where there was likely to be a risk from the delay in an ambulance reaching a patient, call handlers should “consider asking the patient to be transported by friends or family”. This applies to calls including category two, which covers suspected strokes and heart attacks, according to the note seen by HSJ. It said call handlers should “consider all forms of alternative transport” for patients. The note from medical director Mathew Beattie gives the example of a person with chest pain who would normally get a category 2 response – with a target of reaching them within 18 minutes – but where the ambulance response time would be two hours. In the message to staff, Dr Mathew Beattie said: “To manage [current] unprecedented demand, we have no other option than to try and work differently which I am aware will not sit comfortably but is absolutely essential if we are to sustain a service to those who need it most." “We need to weigh up the risk of delays for ambulances against alternative disposition or transport options. Where such risks are considered, I want you to be aware that the trust will fully support you in your decision-making under these circumstances.” Read full story (paywalled) Source: HSJ, 4 January 2022
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